title: Mild vitamin A deficiency and risk of respiratory tract diseases and diarrhea in preschool and school children in northeastern Thailand.
abstract: A cross-sectional study, a follow-up study, and an intervention trial were carried out to investigate the association between mild vitamin A deficiency and the occurrence of diarrhea and respiratory diseases. Cross-sectional analysis was performed among 1,772 children, aged 1-8 years, in the Sakon Nakhon province of northeastern Thailand. Children with a history of diarrhea or respiratory disease had lower levels of serum retinol and retinol-binding protein. Adjusted for age, sex, nutritional status, and level of urbanization, logistic regression using data for 877 children showed a negative association between serum retinol and both diarrhea and respiratory diseases. A follow-up three months later (n = 146 children) showed that children with deficient serum retinol (less than 0.35 mumol/liter) had a fourfold greater risk of respiratory disease (p less than 0.01). No relation was found for diarrhea. An intervention trial (n = 166 children aged 1-5 years) showed that, during 2 months of follow-up after administration of oral vitamin A (200,000 IU), the control group (aged 3-5 years) had a higher incidence of respiratory disease (2.9 times) as well as diarrhea (3.1 times). Between 2 and 4 months, a significantly (p less than 0.025) higher incidence of respiratory diseases (2.5 times) could be observed in children aged 1-2 years. This study supports earlier reports on a greater risk of respiratory diseases and of diarrhea in mild vitamin A deficiency. Supplementation reduced the incidence of both diarrhea and respiratory disease for a period of at least 2 months.
authors.affiliation: Helen Keller International, Dhaka, Bangladesh.
authors.forename: M W
authors.initials: MW
authors.lastname: Bloem
authors.forename: M
authors.initials: M
authors.lastname: Wedel
authors.forename: R J
authors.initials: RJ
authors.lastname: Egger
authors.forename: A J
authors.initials: AJ
authors.lastname: Speek
authors.forename: J
authors.initials: J
authors.lastname: Schrijver
authors.forename: S
authors.initials: S
authors.lastname: Saowakontha
authors.forename: W H
authors.initials: WH
authors.lastname: Schreurs
mesh_terms: D000284:Administration, Oral; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000453:epidemiology* / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D012140:Respiratory Tract Diseases / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D013785:Thailand; D014801:Vitamin A / Q000008:administration & dosage / Q000097:blood; D014802:Vitamin A Deficiency / Q000150:complications / Q000453:epidemiology*
chemical_list: D014801:Vitamin A